You seek a residential treatment community that will give you or someone you care about a brighter future. The task you face is very different from using the Internet to find an attorney, new bank, or electrician. It is a complex endeavor – with high emotional and financial stakes.

How do you find the best fit between person and program, a fit that can turn a life around?

How long should someone keep trying on their own?

Should you be concerned with a program’s location?

To what extent should the person being placed be involved in the search and the decision?

What about the treatment at various facilities?

What are important aspects to consider in choosing a residential community?

What should you be looking for?

When is the “right” time to consider a facility?

You’ve heard that a certain place is “the best.” Should you put it at the top of your list?

To what extent should the person being placed be involved in the search and the decision?

Before you start

What does a "good fit" mean?

A big part of the answer is that there is a good match between the program's services and the individual's needs.

By services, we mean what the program offers; for example, the nature and intensity of treatment and the range of activities.

The other part of a good fit is less tangible; it is the flavor of a place. For the person who will participate in the program, it is a subjective feeling of rightness, a feeling of being "at home." You will get somewhat of a feeling for the atmosphere of a place from its web site when actual photos are used and not stock photos, from speaking with all staff (and not just the admissions person) and of course, from a personal unannounced visit.

Readiness or timing

Is there a “right” time for a person to enter residential treatment?

This can be an emotional and financial issue. It can awaken guilt feelings when the family is ready for placement yet the individual is resisting. There are several points to keep in mind regarding readiness. Sometimes the family is first to recognize that a loved one needs placement. This is common -- and can be perfectly all right. The family may express their realization as, "This can't go on." The family sees the need to set limits on the family member’s behavior and lifestyle. In some cases, they may make further support contingent on the person getting treatment. Sometimes the individual also recognizes that their own efforts haven't worked and that they can’t seem to improve on their own.

And sometimes the individual does not see or admit this, and the family needs to take action anyway.

Either scenario makes sense and can be the driving force for positive change.

It’s best that your family member live close to home, right?

Surprisingly, the answer is often “no.” As you decide how big a role geography will play in your selection of a facility, consider these points. The first point relates to something mental health professionals hear all the time from prospective clients. Someone informs them: “We’re only considering programs on the West Coast.”

Or: “The residence has to be in our state.”

Of course, everyone understands and supports your wish for close contact.

However, it is recommend that the family set no geographical limits on the choice of program.

Instead, let the nature of the program guide your choice. How a facility approaches the healing process is what affects a person’s growth and recovery – not whether it is close or far from home.

What’s more, being far from home can actually help a person make positive changes – perhaps for the first time.

Think about kids going off to college. Often they are freer to find themselves when they are further away from the family.

They come into their own, become their own person, and make remarkable strides forward. Then too, living far from home can force a person to leave behind friends who are poor influences. Getting away means a fresh start on the right foot.

And sometimes the only way it can happen is with a dramatic relocation. Another scenario is that the person’s friends from home have moved on with their lives. As they achieve success and independence they leave the person with issues behind.

This creates feelings of abandonment and also reinforces low self-esteem in people with disabilities, who can’t help but compare themselves to their friends. Moving away and developing new relationships free of negative feelings can open the door to growth and recovery.

Mixed feelings are natural

Spending time in a facility is never part of a person's vision of their own future. So even when an individual recognizes they need treatment, they often have mixed feelings about entering a residential community. Expect this ambivalence, which often express itself as push-pull behavior. The person agrees to go to a program, then pulls back from the decision.

However, their mixed feelings should not be a reason to avoid placement in a community that can change or even save their life. Though it may seem, at the time, insensitive to overrule their ambivalence, it is often in the person's best interests.

When you are the one feeling ambivalent, understand your feelings in this light.

Entering a therapeutic residence was not part of your plan – yet it can bring you to the point where you can realize your plan.

Styles of treatment communities

Please keep in mind that there is a lot of overlap among styles of residential and wilderness treatment facilities. This means that nearly every program, whatever its dominant style, has features of other styles. It is a question of emphasis.

For example, in an adolescent farm-based or work-based program, collective and purposeful work sustaining the farm or other operations is at the core of the therapeutic experience. At the same time, farm-based programs can offer levels of independent apartment living off the farm for young adults. Likewise, an apartment-based program for young adults can revolve around a strong community that offers the benefits of a group environment, much like in a group home.

What’s more, some facilities offer a sequence of care consisting of three or four completely different program styles, each fully developed.

In addition, programs of any style may offer opportunities to continue education or to work at jobs in the community.

This overlapping of styles – and in some cases, the availability of several distinct types of program under the umbrella of one facility -- will be helpful to the person you are placing: It means facilities offer a richness of options within their own programs, which a resident can take advantage of as their needs change or as they grow more independent.

What about cost?

Most of the facilities that are the best and provide long-term results and employ around the clock best trained staff, are not covered by private or public insurance.

This means that the majority are self-pay. For those who need alternatives:

➢ 60+ Options for Low Cost Residential Treatment

➢ Advocacy Journal for Placements and Services

What are the person's challenges?

Often a treatment community has a concentration of people with the same disorder. This concentration may change over time, or it may remain constant. A high ratio of residents struggling with the same issue as your family member may be a positive -- or it may be not productive. When it reflects a facility’s area of specialization, it is a positive. When it does not represent a specialization, this concentration can overburden a facility, in which case it may not be a growth-enhancing situation for you.

Honestly and openly discuss your concerns about the composition of the community with people from the program.

Keeping in mind your family member’s specific issues, initiate a discussion as to whether the current or foreseeable composition of people at the residence will work in your loved one’s favor over time – or not.

Once you start comparing programs

Which approach will work best? As you make your way through the Internet, you will discover many differences among residential and wilderness communities.

How do you know which approach is best for your family member?

For example, how do you know if a same-sex community is best – or not a good idea?

How do you know whether tighter supervision is a good idea – or a recipe for back-sliding?

The answer has several parts: (1) Discuss the person’s needs and the facility’s approach with the people in several departments of the program currently providing treatment. (2) Reflect on your own experience with the family member.

Under what circumstances has the person done better? (3) Discuss everything with multiple people at the facility.

What should you be focusing on?

Besides the style of a program, what other key aspects should you research and compare? Here is a partial check-list to use as you learn about various residences:

Activities: What kind of activities are offered on-site? Artistic? Vocational? Educational? Nutritional support? Exercise? What is mandatory, what is optional? Are residents made aware of special interest activities in the general community? Are they given practical help (such as transportation) in taking advantage of community resources? To what extent are residents helped to find volunteer positions or paying jobs in the community?

Family support services: How easy are family meetings to arrange? Are treatment decisions made with the family? Is there ongoing family communication? What is the balance between respect for the confidentiality of the student participating in the program and respect for the need for progress updates on the part of the family who is paying? Ask directly about all these communication issues, in particular, pinpointing the process of communication among facility, resident and family.

Involvement of the staff: What is the ratio of staff members to residents . . . and are you happy with this? What is the level of supervision? How much interaction is there between staff and residents? Do staff members form supportive relationships with residents? What do administrators look for in staff . . . what qualities are valued?

Level of expectation of a resident: On a daily basis, how much participation in the program is expected of a resident?

Are they required to take part in structured activities for a certain number of hours a week? Or, can they choose to not participate in much? What are the behavior guidelines regarding such things as expression of anger, relationships with peers, and smoking? How does the facility respond to violations of these guidelines?

Medication monitoring: What is the level of supervision of this activity? Is there a procedure by which residents move (at their own pace) toward independent taking of meds? Does staff provide education about medication? Who dispenses the medication and what is their background, education and training?

Peer group: What is the age range of residents? What is the gender make-up? What is the range of disorders?

Therapeutic approaches: Is clinical treatment offered on-premises? What kind of treatment (for example, individual or group psychotherapy, vocational development, treatment for co-occurring addictions)? How often? Or, is clinical treatment available only off-premises? Is it mandatory or optional? For a person who can benefit from it, we recommend the more intense approach to treatment – on premises, of several types and frequent. However, for a young adult who cannot benefit from intensive treatment, it may make sense to attend a program that works vigorously to connect residents with mental health resources in the surrounding community, to the extent that the person can benefit from them.

Family’s contribution to finding the best place

You contribute something to this search no one else can: You have had the longest and most intimate contact with the person in distress.

This gives you a unique and valid perspective on your loved one’s ups and downs over the long haul. It is important that you share your observations and insight with people from the programs you are considering. It is also important that you share your perspective with the person who will participate in the program, when appropriate. Resist the temptation to “sell” your family member to a program you have decided is the right one. Instead, let one place’s rightness emerge over time, as you offer forthright information. In the same vein, do not force a fit into a program you’ve heard is “the best.”

No program is best in absolute terms.

A facility is the best when it meets the needs of the person who needs help. If, after conversations with people at a treatment residence, it turns out the place is not right for your family member, professional treatment centers will suggest other residential communities, or someone you can call for assistance, such as a therapeutic consultant.

Collaboration between the consultant, your student and family is the foundation of their joint efforts in providing services.

Collaboration of the person participating in a program

All programs are most effective with the voluntary collaboration of the person who is participating. And your family member’s collaboration starts with the selection process.

We encourage you to enlist your loved one as a partner as you research and compare residential treatment communities, when appropriate. For the person in need, this can be that all-important first, concrete step in pulling their life together.

How does this partnership work? After you have narrowed the choice down to two or three likely facilities, direct your family member to those web sites. Suggest they jot down questions or concerns about any aspect of the programs. Participating in the selection process means your loved one is already buying into making a positive change in their life. There is no one right path to finding a good match between the person you care about and a residential program. There are infinite paths.

What you have read here are suggestions. By being a good detective and remaining open-minded, patient and persistent, you will achieve your goal.

You are urged you to inform yourself of all residential and wilderness treatment options before narrowing down your search.

Author's Bio: 

From assessment services to placement in specialized clinical and treatment settings, HFS is known for assisting clients to navigate through the maze of program and school confusion to provide a very select and stylized form of educational and/or treatment planning.

From independent programs and schools to therapeutic communities, and to expert consultation, Horizon Family Solutions Educational, Therapeutic & Placement Services is there to provide options. We provide a student and family with individual attention, firsthand knowledge of hundreds of educational and therapeutic opportunities, and the time to explore all of the options. Finding the perfect program or school for the individual and their family is our mission.

We have and continue to travel extensively: investigating programs and schools.

Why settle for someone with less education, experience, expertise and training.